Losartan
Losartan
CLINICAL USE
Angiotensin-II receptor antagonist:Hypertension Type 2 diabetic nephropathy
DOSE IN NORMAL RENAL FUNCTION
25–100 mg daily
PHARMACOKINETICS
Molecular weight                           :461 %Protein binding                           :>98 %Excreted unchanged in urine     : 4 Volume of distribution (L/kg)       :0.4half-life – normal/ESRD (hrs)      :1.5–2.5 (active metabolite 3–9)/4–6 DOSE IN RENAL IMPAIRMENT
GFR (mL/MIN)
20 to 50     : Dose as in normal renal function 10 to 20     : Initial dose 25 mg and titrate according to response <10           : Initial dose 25 mg and titrate according to response DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES
CAPD                :Not dialysed. Dose as in GFR <10 mL/min HD                     :Not dialysed. Dose as in GFR <10 mL/minHDF/high flux   :Not dialysed. Dose as in GFR <10 mL/minCAV/VVHD      :Not dialysed. Dose as in GFR=10–20 mL/min IMPORTANT DRUG INTERACTIONS
Potentially hazardous interactions with other drugs Anaesthetics: enhanced hypotensive effect Analgesics: antagonism of hypotensive effect and increased risk of renal impairment with NSAIDs; hyperkalaemia with ketorolac and other NSAIDsCiclosporin: increased risk of hyperkalaemia and nephrotoxicity Diuretics: enhanced hypotensive effect; hyperkalaemia with potassium-sparing diuretics Epoetin: increased risk of hyperkalaemia; antagonism of hypotensive effect Lithium: reduced excretion (possibility of enhanced lithium toxicity) Potassium salts: increased risk of hyperkalaemia Tacrolimus: increased risk of hyperkalaemia and nephrotoxicity ADMINISTRATION
Reconstition
– Route
Oral Rate of Administration
–Comments
– OTHER INFORMATION
Adverse reactions, especially hyperkalaemia are more common in patients with renal impairmentRenal failure has been reported in association with angiotensin-II antagonists in patients with renal artery stenosis, post renal transplant, and in those with congestive heart failureClose monitoring of renal function during therapy is necessary in those with renal insufficiencyLosartan potassium.
See how to identify renal failure stages according to GFR calculation
See how to diagnose irreversible renal disease
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